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Author
Topic: A few questions.... (Read 1272 times)

On January 10th I had intercourse with someone whom I had been with more than a few times. On Sunday he called me and said he had just tested positive for HIV. I of course proceeded to freak out for a few days before settling down and doing some research and stumbled onto this place. So I suppose I have a few questions.

Our last encounter (1-10) was the only time we had unprotected anal sex. Every other time we had been together over the past 10 months we used protection. I had simply run out of condoms and with this not being some random one night encounter I (naively) extended my trust too far. He usually gets tested once a year so he is unsure of when he was first infected. All other STI tests came back clean. I am 25 and circumcised. The anal sex itself lasted no more than 10 to 15 minutes and I did not ejaculate. We did use some toys beforehand and we used plenty of lube. I was the insertive partner. He is, quite honestly, a mess right now so I havenít really be able to quiz him about viral load and whatnot and I didnít want to bombard him with questions two days into his diagnosis. I know the risk is on the lower side for the insertive partner but itís some that can vary a bit. I have been sick the past few days, but it just seems to be a sinus infection (which I get a lot) so I'm not worried about that. So I guess my first question is: In you allís experiences, what is the risk for an insertive top with a poz partner not on medicine? I know it's a hard question too answer but I thought I would ask anyway.

My second question is about testing. I am scheduled to have knee surgery soon (around 40/45 days from my possible infection date). I called my doctor immediately after I found this out and she was pretty adamant I come in for a blood test right away, plan out more blood test down the line, and too discuss things. From what Iíve seen itís too soon to get a reliable result but my question is could I trust a test 40 to 45 days after a possible infection? I donít want to put anyone at risk during the surgery and I donít want to get a false negative and assume it right.

OK, for a start, I hope you've been testing regularly since you became sexually active and know for a fact that you were hiv negative before this encounter.

As the insertive partner, you very much were at lower risk and considering you only had unprotected intercourse the one time, odds are very much in your favour that you'll come out of this ok and hiv negative.

But you do need to test.

A test now (at three weeks) would mainly give you a baseline - ie were you negative before this incident. However, if you are recently infected (Jan 10th), it just might give you an indeterminate result. An indeterminate at three weeks would most likely be a full positive by four weeks - but indeterminates can also be false results.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, with the average time to seroconversion being only 22 days.

A six week negative must be confirmed at the three month point, but is highly unlikely to change. A negative test result at 40/45 days would likewise be highly unlikely to change. (six weeks = 42 days)

As for your scheduled surgery, your hiv status really doesn't make that much difference. People who are hiv positive have surgery all the time.

It certainly makes no difference in regards to your comment "I donít want to put anyone at risk during the surgery" - this is where your hiv status makes absolutely NO difference.

Any surgeon whose degree is worth the paper it's printed on will assume ANYONE they operate on has a blood borne virus and protect themselves accordingly through what's called Universal Precautions. The same goes for the OR team.

Universal precautions protect both the health care provider and the patient, so if your surgeon gives any indication that he/she does not rigorously follow UPs (such as being worried about infection regarding hiv), then RUN, do not walk, out the door. This is regardless of what your test results turn out to be. I never trust a surgeon who isn't up to scratch on UPs.

The only difference your hiv status (if poz, which is not likely) would make to the surgery is that the doctor might want to be a little more pro-active concerning after-surgery infection. And that's it, particularly at this stage of the game where you'd be dealing with a new infection. If you are, which I doubt.

I do expect you'll come out of this ok. It would be unusual and unfortunate to end up infected following only one incident of unprotected insertive intercourse. But yes, you absolutely must test to find out one way or the other. Good luck.

By the way, you're right to not badger your friend with questions right now. He likely won't even know his viral load at this point as those tests typically take two weeks to return from the lab.

However, one test you SHOULD ask him about is whether or not his positive test result has been confirmed through further testing with a Western Blot. Only when a person has had their results confirmed through further testing are they truly considered to be hiv positive. False positive results do happen, particularly on rapid tests. Please make sure his diagnosis has been confirmed.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts